Taking measure of health and wealth

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ANN ROMNEY doesn’t consider herself wealthy. Because she suffers from multiple sclerosis, she counts her riches differently, she told a recent interviewer. She measures them “by the friends I have and the loved ones I have.’’

As she knows, illness is the great equalizer, since it strikes without regard for net worth. But it can also be the great divider, in terms of access to health care. That’s what health care reform is aimed at changing and what her husband once championed.

Under Governor Mitt Romney’s leadership, Massachusetts passed a law that equalizes health care access for rich and poor. Yet as he gets closer to securing the Republican presidential nomination, Romney fervently pledges to repeal national health care reform. With that pledge, he’s also promising to deny millions of average Americans the same access to medical care his wife has, simply because she married a man who came to be worth $250 million.

Disease is not deterred by Romney’s bank accounts. But his money gives Ann Romney access to the best doctors, the best treatments, and the lifestyle most conducive to coping with MS, including horseback riding. No one begrudges her that. But the difference between what his wife can afford and what is available to a person of lesser means is the driving issue behind national health care reform — and Romney knows it. But to win the GOP nomination, Romney must walk away from the equity principle behind Romneycare and Obamacare, and so he does.

In America, illness “is yet another way the advantaged and the disadvantaged get divided,’’ said John McDonough, a force behind health care reform in Massachusetts, and later in Washington as senior adviser to the late Senator Edward M. Kennedy. “The Affordable Care Act is the law which promises to remove this stain of discrimination from our nation. It already has begun.’’

Wealth could not inoculate Kennedy from illness; that was clear when he was diagnosed with brain cancer. But it gave him access to top-notch medical care. Throughout his life, Kennedy viewed a two-tiered health care system, with wealth as the dividing line, as the antithesis of American values. That’s why he worked with Romney to come up with a compromise health care reform law that both men hoped could serve as a bipartisan model for the nation.

Today, Romney says the universal health care model he promoted as governor is fine for Massachusetts but a disaster for America.

The difference between what quality of care Ann Romney can afford and what is available to a person of lesser means is the driving issue behind national health care reform.

But what if Romney weren’t so rich and the wife he loves was diagnosed with MS? He would confront a more personal kind of disaster.

“MS is a chronic condition. People live with it for decades. They are able to live good lives, because of access to very expensive drugs that cost tens of thousands of dollars a year. Most people couldn’t afford it without insurance,’’ said Philip J. Edmundson, a universal health care advocate and chairman of William J. Gallagher Associates, the largest New England benefits insurance broker.

Because of Romney’s leadership in Massachusetts, Ann Romney could not be denied health insurance because of a pre-existing condition. In other states, she could be. That would change under the national health care reform act. If it kicks in as scheduled in 2014, an estimated 30 million more citizens “can get something approaching the type of care that Ann Romney receives,’’ said Edmundson.

Does Romney really want to stop that, as he salutes the right by promising to repeal Obamacare?

Polls show that one of Romney’s biggest problems is an inability to convince ordinary citizens he cares about them. When he goes off-script, he awkwardly spotlights the bubble of enormous wealth that shields him from the uncertainties of middle-class life on the edge. Examples include his cracks about being unemployed; liking to fire people who don’t give him good service; not being much of a NASCAR fan, but knowing plenty of owners; and his wife’s two Cadillacs.

Ann and Mitt Romney are grateful for their own blessings and admirably generous when it comes to charitable giving. But they seem to have trouble understanding just how different their lives are from everyone else’s. Or maybe they simply have trouble putting the difference into the right words, whether the subject matter is luxury cars or luxury health care.